Ultrastaging Using Ex Vivo Sentinel Lymph Node Mapping and One-Step Nucleic Acid Amplification (OSNA) in Gastric Cancer: Experiences of a European Center.

OSNA gastric cancer histology lymph node staging one-step nucleic acid amplification

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
29 May 2021
Historique:
received: 30 03 2021
revised: 11 05 2021
accepted: 27 05 2021
entrez: 2 6 2021
pubmed: 3 6 2021
medline: 3 6 2021
Statut: epublish

Résumé

In this study, the effectiveness of One-step nucleic acid amplification (OSNA) in combination with ex vivo SLN mapping is compared with conventional histology including immunohistochemistry. LNs were retrieved from gastrectomy specimens in an unfixed state. After ex vivo SLN mapping using methylene-blue, LNs were sliced to provide samples for histology and OSNA. In total, 334 LNs were retrieved in the fresh state from 41 patients. SLN detection was intended in 40 cases but was successful in only 29, with a correct LN status prediction in 23 cases (79%). Excluding one case out of 41 with a failure likely caused by a processing error, OSNA showed a high effectiveness with sensitivity, specificity, and accuracy rates of 85.4%, 93.5%, and 92.4%, respectively. The LN status could be predicted in all but one case, in which the single positive LN was not eligible for OSNA testing. Moreover, OSNA evaluation led to upstaging from N0 to N+ in three cases (14%). The ex vivo SLN protocol used resulted in a relatively poor detection rate. However, the OSNA method was not hampered by this detection rate and proved its potential to increase the sensitivity of metastases detection.

Sections du résumé

BACKGROUND BACKGROUND
In this study, the effectiveness of One-step nucleic acid amplification (OSNA) in combination with ex vivo SLN mapping is compared with conventional histology including immunohistochemistry.
METHODS METHODS
LNs were retrieved from gastrectomy specimens in an unfixed state. After ex vivo SLN mapping using methylene-blue, LNs were sliced to provide samples for histology and OSNA.
RESULTS RESULTS
In total, 334 LNs were retrieved in the fresh state from 41 patients. SLN detection was intended in 40 cases but was successful in only 29, with a correct LN status prediction in 23 cases (79%). Excluding one case out of 41 with a failure likely caused by a processing error, OSNA showed a high effectiveness with sensitivity, specificity, and accuracy rates of 85.4%, 93.5%, and 92.4%, respectively. The LN status could be predicted in all but one case, in which the single positive LN was not eligible for OSNA testing. Moreover, OSNA evaluation led to upstaging from N0 to N+ in three cases (14%).
CONCLUSION CONCLUSIONS
The ex vivo SLN protocol used resulted in a relatively poor detection rate. However, the OSNA method was not hampered by this detection rate and proved its potential to increase the sensitivity of metastases detection.

Identifiants

pubmed: 34072392
pii: cancers13112683
doi: 10.3390/cancers13112683
pmc: PMC8198451
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Transl Gastroenterol Hepatol. 2017 Mar 15;2:15
pubmed: 28447050
Visc Med. 2020 Oct;36(5):364-372
pubmed: 33178733
Int J Clin Oncol. 2017 Feb;22(1):3-10
pubmed: 27549784
Hum Pathol. 2016 Feb;48:132-41
pubmed: 26614398
Gastric Cancer. 2014 Apr;17(2):316-23
pubmed: 23933782
Ann Surg Oncol. 2015 Mar;22(3):980-6
pubmed: 25190122
Gastric Cancer. 2020 May;23(3):418-425
pubmed: 31667687
World J Gastroenterol. 2015 Feb 7;21(5):1628-35
pubmed: 25663783
Lancet Oncol. 2010 May;11(5):439-49
pubmed: 20409751
Ann Surg Oncol. 2011 Jul;18(7):1860-8
pubmed: 21503792
J Cancer. 2018 Nov 24;9(24):4611-4617
pubmed: 30588244
Hum Pathol. 2016 Oct;56:16-21
pubmed: 27342907
Ann Surg Oncol. 2011 Aug;18(8):2289-96
pubmed: 21301968
Oral Oncol. 2012 Oct;48(10):958-963
pubmed: 22516375
Eur J Surg Oncol. 2014 Mar;40(3):263-9
pubmed: 24368050
Colorectal Dis. 2016 Dec;18(12):1147-1153
pubmed: 27218666
Ann Surg Oncol. 2020 Apr;27(4):1077-1083
pubmed: 31722072
Front Surg. 2019 Jan 22;5:77
pubmed: 30723718
Nature. 2014 Sep 11;513(7517):202-9
pubmed: 25079317
Breast Cancer Res Treat. 2013 May;139(1):87-93
pubmed: 23576079
Breast. 2018 Jun;39:39-45
pubmed: 29574393
J Surg Oncol. 2009 Mar 15;99(4):199-206
pubmed: 19142901
J Transl Med. 2017 Jan 14;15(1):14
pubmed: 28088238
J Microbiol. 2015 Jan;53(1):1-5
pubmed: 25557475
Gastric Cancer. 2014 Apr;17(2):273-80
pubmed: 23743877
Ann Surg Oncol. 2016 Feb;23(2):391-6
pubmed: 26438440
Gastric Cancer. 2019 Jul;22(4):873-880
pubmed: 30603913
Ann Surg Oncol. 2012 Oct;19(11):3449-59
pubmed: 22644513
World J Gastrointest Endosc. 2020 Apr 16;12(4):119-127
pubmed: 32341748
Lung Cancer. 2012 Dec;78(3):212-8
pubmed: 23026640
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593

Auteurs

Bruno Märkl (B)

Institute of Pathology and Molecular Diagnostics, University Hospital Augsburg, 86156 Augsburg, Germany.

Bianca Grosser (B)

Institute of Pathology and Molecular Diagnostics, University Hospital Augsburg, 86156 Augsburg, Germany.

Kerstin Bauer (K)

Institute of Pathology and Molecular Diagnostics, University Hospital Augsburg, 86156 Augsburg, Germany.

Dmytro Vlasenko (D)

Department of Visceral Surgery, University Hospital Augsburg, 86156 Augsburg, Germany.

Gerhard Schenkirsch (G)

Tumor Data Management, University Hospital Augsburg, 86156 Augsburg, Germany.

Andreas Probst (A)

Medicine III-Gastroenterology, University Hospital of Augsburg, 86156 Augsburg, Germany.

Bernadette Kriening (B)

Department of Visceral Surgery, University Hospital Augsburg, 86156 Augsburg, Germany.

Classifications MeSH